Substance Use Disorders

Addictions and Emotions

Experts say that people with addictions may need to deal with mental issues.

Most people who have an addiction problem also have an emotional problem. The problem might be depression. It might be anxiety. It could be an eating disorder. It’s called “dual diagnosis.” This means two problems at once.

A related emotional problem can make it hard to fight an addiction. This can really happen if you’re doing it on your own. That’s why the two issues should be treated at the same time. It’s called dual recovery. It offers real hope.

Treatment

You may hear the message that you need to get clean before you can work on an emotional problem. That doesn’t always work. Getting help for an emotional problem can help your addiction recovery. Treatment for both can help you break the link between feeling sad and using substances.

You also may have heard that using prescription medication is as bad as abusing a substance. That’s not true. Such pills don’t make you high. They’re given in a controlled way. They help you feel normal.

Steps to Take

A good first step to take when getting help for an emotional problem is to learn more about it. Research it on the Web. Read a book about it. A professional evaluation is needed for mental problems. You don’t have to take medication or go to therapy if you feel uncomfortable with either of those options. Just finding out more may be helpful.

Some people worry that a diagnosis will mean they’re crazy. They may believe that they’ll be taken to a hospital against their will. They may be afraid of medication. They may think therapy is only for weak people. These are not true. You can turn to new medications. You can turn to psychotherapies. You can turn to self-help groups. Books can help with emotional problems.

You may wonder which problem came first. Experts say answering that question isn’t as important as following this rule.

A Typical Story

Here’s a hypothetical story of a person diagnosed with both problems who decided to get help:

Kevin is a manager who’s terrific at his work. He began having a drinking problem in college. He graduated from college and began spending too many nights entertaining clients. He knew he had a problem because he always ordered more drinks than others. He started to drink even before going out. He tried to find help through his company’s employee assistance program. They referred him to a psychiatrist for an evaluation. Kevin was surprised to find that the psychiatrist diagnosed him with a mood disorder called hypomania. He was also diagnosed with an alcohol problem.

Hypomania causes high moods. It causes racing thoughts or speech. It increases activity. It causes irritability. It takes away the need for sleep. The symptoms can lead to poor decisions. Many people with hypomania become addicted to alcohol or drugs.

Kevin knew his moods could be strong. He never knew there was a name for it. He did not know that pills could help. He went to Alcoholics Anonymous. He took the medication his doctor prescribed. He was able to get control over his alcohol problem. His moods became more stable. He also learned that hypomania can run in families. Kevin felt lucky that it was caught early.

Common Emotional Problems

Here are some common problems that addicted people may have:

Depression. Feeling down and blue. Being unable to shake loose from it.

Posttraumatic stress. After surviving or witnessing a physically harmful experience.

Obsessive compulsive disorder. You feel the need to keep doing some action over and over.

Generalized anxiety. Trouble with nerves. This may feel like a lot of worrying. Or a lot of physical problems.

Phobia. Your fear of something causes big problems in your life.

Eating disorder. You use food to deal with emotional pain.

Personality disorder. You relate to others in ways that cause serious problems.

Everyone has some emotional issues at times. A disorder means you have an ongoing problem that gets in the way of living a normal life.

How to Get Help

There are a lot of ways to get help. Contact your employee assistance program. Call a mental health center. Try the Yellow Pages for listings under mental health. Several national nonprofit organizations can give you information.

The most important thing to know is that you have choices. You can take medication. You can get therapy. You can join a self-help group. Just learning about an emotional problem may be helpful. You can decide from there if you want to do more.

You may not want to hear that you have another problem to deal with if you’re already dealing with an addiction. Some dually diagnosed people actually feel a sense of relief to get a diagnosis that puts them on the path to a true recovery.

Misusing Alcohol or Drugs

Help for People with an Alcohol Problem

Help is out there for people with an alcohol problem. People may need different types of help. How much they are drinking, how long they have had the problem and resources available where they live will help know what kind of help will work for them.

Many people first need to get the alcohol out of their body. This should be done through a doctor or hospital. They may also talk to their doctor about taking medicine. Going to meetings where other people have the same problem also helps a lot. Through these meetings, people can learn to spot when they have feelings that make them want to drink and finding new ways to get over those feelings in a positive way. A doctor can help find good resources in the area.

A drinking problem can be hard on everyone living with that person. It is important for everyone to get help. They need to learn about the problem and how they can help the person get better. They can get help for their marriage and for everyone in the family. Many places can help the person with the drinking problem:

find resources in their area

locate help for legal problems

learn new jobs

teach people how to be a parent and care for their children.

Alcoholics Anonymous (AA)

Many programs include AA meetings that can help a person with a drinking problem. Going to an AA meeting can help a lot. In this type of meeting, people with the same problem get together to support each other and learn ways to stay away from alcohol. While this type of group can help a lot of people, it may not help everyone. Each person needs to find out what will help them the most. A person may feel more comfortable talking to someone on their own. But they should always work with their doctor at the same time.

Can It Be Cured?

An alcohol problem can be helped, but a cure is not available. That means that even if a person has not had a drink for a long time and is in better health, he or she may still have times when they want to drink, but they stay away from all alcohol. “Drinking less” doesn’t work; stopping all drinking is the only way to be successful.

Even people who may want to stop drinking may have a hard time and have a drink. It happens to a lot of people but they can still stop drinking for good. Every day that a person doesn’t drink is important. If it does happen, it is important to stop drinking again and get help right away.

Help for an Alcohol Problem

If the doctor says that a person is getting better but is still using alcohol for the wrong reasons, the doctor can:

Show how good the person will feel when they stop drinking and how healthy they will be.

Help set goals to stop drinking. Some people choose to stay away from alcohol, while others want to limit how much they drink.

Help look at the times and places that make the person want to drink and find new ways of getting through those times so that they can reach their goal.

Sometimes people have stopped drinking after getting in trouble or they have had an accident. �While they may have stopped drinking, they still haven’t called a doctor for help. Going to AA meetings to talk to other people can help these people a lot.

New Directions

There are people that are looking at what makes people have a drinking problem. They want to find new ways to help these people. They also want to keep other people from having a drinking problem. Most of the studies on alcohol problems are being paid for by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and they are finding out a lot.

Family history:

People are working with families to learn about their past. When they look at this they can tell what may make a person have a drinking problem. They have found many genes that may have an effect on people. Now they can tell the type of person that are more likely to drink and help find new ways to help these people before it becomes a problem.

Treatment:

There are three common ways to help a person with a drinking problem. They have found that each way helped alcohol problems a lot just after one year. About 1/3 of the people involved in the study were still not drinking after three years.

New Medicine:

The NIAAA is looking at new medicines. At the same time, they are looking at the reasons why and when people drink. One drug, Naltrexone (ReVia), is already approved by the Food and Drug Administration. Naltrexone may lessen the need to drink by blocking part of the brain. Another drug, Acamprosate, may keep a person from wanting a drink by making them feel better.

They are also looking at other important areas. They are looking at what drinking does to the brain and other body parts. They are also looking at what it does to that person’s unborn baby.

They are finding out what adds to a drinking problem. It also shows ways to avoid problems that may happen when people drink and new care. These studies will help people to not even start drinking, knowing what to look for. It will also help with new care and resources for people and their families.

Alcoholism

Most all of us have seen the out of control acts of a problem drinker. But, at what point does problem drinking becomes alcoholism?

Problem drinking becomes alcoholism when the person:

Drinks without thinking or caring about it

Keeps drinking in spite of the harm it causes

Gets mad when they can’t have alcohol

Not all people who get drunk are alcoholics. People drink at parties. People drink to get attention. For alcoholics, though, their drinking can’t be controlled.

What Causes Alcoholism?

Some doctors believe that alcoholism can be passed on through the family. Others believe that some people are just more likely to get the disease. People handle alcohol differently:

Some people avoid alcohol because it disagrees with them

Others enjoy some alcohol, but stop drinking as soon as they get dizzy or sleepy

Others have no sense of when they should stop drinking; when they drink, they get drunk

The people in this third group may be more likely to be alcoholics. It is not a weakness, but part of their body’s make-up.

How Can You Tell Who Will Become An Alcoholic?

You can’t. There is no test that can see if a person will become an alcoholic. But there are two important clues:

Children of alcoholics have a much bigger risk of getting the disease.

People who drink a lot and become angry when they can’t drink are at risk.

Alcoholics Suffer From Their Illness

As their disease gets worse, they need to drink more just to feel normal. They know that once they start to drink, they can’t stop. But they want to keep from getting drunk to avoid being embarrassed. They want to avoid feeling bad when they stop drinking – such as trembling, irritability, nausea, or insomnia. They may try different things to control their drinking. They may switch from liquor to wine. They may try going “on the wagon.”

Nothing works for long, though. Relationships can fall apart. Work suffers. Health problems develop. Alcoholics have blackouts and don’t know what they have done. They may feel edgy and take pills to calm down. But they may get addicted to those as well. Alcoholics eat poorly. Their body is so out of step that it’s hard to keep food down. Their sex drive goes away. They can’t sleep.

Their Loved Ones Suffer Too

Women should not drink when pregnant. If they do, they are giving straight alcohol to their unborn baby. The baby can be born with obvious physical defects. The baby can have severe mental retardation. None of this can be cured.

Alcoholics often have problems with relationships. Alcoholics tend to put their need to drink first. They can be irresponsible. They can lash out at others.

Alcoholics have a hard time being a parent. They may neglect their children. They may lash out at their children. Growing up with an alcoholic parent can leave deep emotional scars.

Alcoholism Can Kill

People with full blown alcoholism drink almost all the time. They have trouble keeping a job. They relate poorly to others. They may be self-destructive. They may have thoughts of suicide. Some of the serious physical problems with late stage alcoholism are convulsions, hallucinations, mental confusion, partial paralysis and cirrhosis of the liver. Untreated alcoholism can be fatal.

There is Good News

Alcoholics can be helped. And most alcoholics can learn to live without drinking.

People used to think the only way to quit drinking was to just stop. But that can be difficult and dangerous. Problems include:

Hallucinations

Convulsions

Dangerous shifts in blood pressure and heart rate

A safer way is to quit drinking while being watched in a hospital setting. “Detox,” involves:

A physical exam

Bed rest

Nursing care

Short-term tranquilizers

A balanced diet

Vitamin and mineral supplements

After a few days, the alcoholic moves into the second stage of care. This stage is called “rehabilitation”. It can be in the hospital or in an outside clinic.

The third stage is the return to a full life. The person may still get medical care with follow up visits, and should be involved in a 12-Step support group. Those who maintain ties to a support group have a better chance of a lasting recovery.

Do You Think You Have a Drinking Problem?

If you have ever thought that your drinking may be turning into a problem, ask yourself these three questions:

Am I drinking more than I used to?

Once I start, am I sometimes unable to stop?

Do I get angry when I’m in a place where I can’t drink?

Answering “yes” to even one of these questions suggests that you may have a problem with your drinking.

If you are still not sure, get advice from an alcohol or drug care center or through your EAP, if you have one.

Does Someone You Know Have A Drinking Problem?

The biggest step is getting that person to admit there is a problem. This may not be easy. Most alcoholics say they can control their drinking. They won’t listen when people say they should quit.

You might ask your family doctor for advice. Or check the phone book for alcohol and drug help centers. Most centers offer “intervention counseling”. This can help you and others plan how to talk to the person about his or her drinking.

It’s True

Most alcoholics are alcoholics for life. They can’t have even one drink. But alcoholics who want to get better make the decision not to drink. They take life one day at a time. And many alcoholics do get better.

Hope Lies in Learning More

The more you learn about this disease the better. You will understand that it is an illness and people can get better. Getting the right help can make the difference.

Methods of Treatment to Help Drug Addiction

Drug addiction can be helped. Treatment can be made to fit a person´s needs. People can learn to control their state. They can live normal, useful lives. People in treatment for this problem can learn to change how they act. They also often take medicines to help them.

Therapy that can help includes the following:

counseling

support groups

family therapy

Medicine is needed to help with the side effects when someone stops taking drugs. It helps reduce the drug craving. It also helps block the drug effects. Treatment for heroin addiction using methadone combined with therapy helps reduce death rates. It also helps with many health problems linked to heroin abuse.

Better results are often found when more treatment is given. Many patients require other services such as:

medical

mental health, and

HIV prevention services

Those who have more than three months of treatment have a better chance than those who do not. Treatment reduces drug intake and the amount of crime. It has also been found that people who have had treatment are more likely to have jobs.